Change 146 Manual of the Medical Department ... - Navy Medicine

Physical Examinations and Standards Article 15-106
(11) Gastroesophageal reflux disease
that is adequately controlled and under appropriate
follow up is not disqualifying.
(h) Genitourinary
(1) History of Urolithiasis
(a) Is disqualifying for candidates.
(b) A first episode of uncomplicated
urolithiasis is not disqualifying for submarine
designated personnel provided that there is no
predisposing metabolic or anatomic abnormality and
there are no retained stones. The attending UMO may
return the member to full duty after a thorough
evaluation to include urology consultation.
(c) A first episode of urolithiasis
associated with a metabolic or anatomic abnormality
is disqualifying. Waiver may be considered based
upon evidence of correction of the associated abnormality.
(d) Recurrent urolithiasis, regardless
of cause, is disqualifying with no possibility of
waiver.
(e) Randall’s plaques are not disqualifying.
(2) Female Reproductive System
(a) Recurrent or chronic pelvic
pain of sufficient severity that it interferes with
performance of duties or poses a MEDEVAC risk is
disqualifying.
(b) Abnormal vaginal bleeding of
sufficient severity that it interferes with performance
of duties, causes symptomatic anemia, or poses a
MEDEVAC risk is disqualifying.
(c) Endometriosis is disqualifying.
(d) Uterine fibroids are disqualifying
if symptomatic.
(e) Cervical dysplasia or neoplasia
requiring frequent follow up (more often than every 6
months) is disqualifying.
(f) Pregnancy is not disqualifying,
but the pregnant submariner may not get underway
on a submarine for the duration of the pregnancy.
After a pregnancy, the submariner may not get
underway on a submarine until cleared by her maternity
care provider and a UMO.
(i) Endocrine and Metabolic. Any condition
requiring chronic medication or dietary modification
is disqualifying for candidates but may be
waiverable for qualified submariners. Additionally:
(1) Diabetes mellitus is disqualifying
(a) Diabetes mellitus requiring
insulin shall not be considered for a waiver.
(b) Diabetes mellitus controlled
without the use of insulin may be considered for a
waiver. Waiver requests must include documentation
of current medications, current hemoglobin A1C
level, and documentation of the presence or absence
of any end organ damage.
(2) Prediabetic conditions requiring
treatment with medication are disqualifying.
(3) Gout that does not respond to treatment
is disqualifying.
(4) Symptomatic hypoglycemia is disqualifying.
(5) Chronic use of corticosteroids is
disqualifying.
(j) Musculoskeletal
(1) Conditions resulting in decreased
strength, decreased range of motion, or pain sufficient
to interfere with ready movement about a
submarine or performance of duties are disqualifying.
(2) Disorders causing a person to be
excessively prone to injury are disqualifying.
(3) Any disorder that precludes quick
movement in confined spaces or inability to stand or
sit for prolonged periods is disqualifying.
(k) Psychological and cognitive. Psychological
fitness for submarine duty must be carefully
and continuously evaluated in all submarine personnel.
It is imperative that individuals working in
this program have a very high degree of reliability,
alertness, and good judgment. Any current or history
of an Axis I diagnosis as defined by the current
15-93a Change 146 23 Jan 2014